Ask the Doctor: ‘I have been on antibiotics three times in the past six months — is this harmful?’

“I have been on antibiotics three times in the past six months, twice for a chest infection and once for tonsillitis. I know it’s not great to be on antibiotics too often and I am wondering if I have done myself harm by being on them three times so close. Will they still work for me if I need them again or should I be getting worried?”

Answer from Laura Gittinger, Pharmacist, Beacon Hospital

Firstly, it is great that you are aware of the problems associated with overuse of antibiotics. Antibiotics are important drugs. Many antibiotics can successfully treat infections caused by bacteria. They can prevent the spread of disease and can reduce serious disease complications. However, it is important to be aware that antibiotics only treat certain infections caused by bacteria. They do NOT work on viruses and are not always needed for some common bacterial infections such as many sinus infections.

Your concern with whether antibiotics will continue to work in the future is known as “Antimicrobial resistance”. Some antibiotics that used to be typical treatments for bacterial infections now don’t work as well, and some drugs don’t work at all against certain bacteria. When an antibiotic no longer works against some strains of bacteria, those bacteria are said to be antibiotic resistant.

Antibiotic resistance is one of the world’s most urgent health problems. The overuse and misuse of antibiotics, especially taking antibiotics when they are not the correct treatment, are key factors leading to antibiotic resistance.

Misuse is when you use antibiotics for the wrong reason: most colds and flu are caused by viruses against which antibiotics are NOT effective. In such cases, you won’t improve your condition by taking antibiotics; antibiotics don’t lower fever or alleviate symptoms like sneezing, and they may harm the good bacteria that you need for a healthy immune system.

Misuse is also when you use antibiotics incorrectly; if you shorten the duration of treatment, lower the doses, don’t comply with the right frequency (taking the drug once a day instead of 2 or 3 times a day), you won’t have enough drug in your body and the bacteria will survive and may become resistant.

The proper use of antibiotics — often called antibiotic stewardship — can help reduce the development of antibiotic resistance. Both healthcare professionals and the public play an important role in antibiotic stewardship. You can help in the following ways:

Always follow your doctor’s advice on when and how to use antibiotics. Use antibiotics only as prescribed. Take the prescribed daily amount. Complete the entire treatment. Never take leftover antibiotics for a later illness – they may not be the correct antibiotic and they likely don’t include a full treatment course. Never take antibiotics prescribed for another person or let anyone else take your antibiotics.

If you do have to take antibiotics it is important to take them correctly and for the duration prescribed. For most illnesses, like those you mentioned, a course of 5 days is now preferred. Depending on your symptoms your GP may also consider a “delayed antibiotic strategy” where you monitor your symptoms and only start the antibiotic if symptoms do not improve in 48 hours.

Always discuss the risks and benefits of taking an antibiotic with your doctor before considering an antibiotic. This way we can ensure we preserve antibiotics for future generations.

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